Lethal Means Counseling – State of the research and best practices

Access to lethal means, such as firearms, are a significant risk factor for adolescent suicide and homicide. Suicide is the second leading cause of death among adolescents in the US. Adolescent suicide death rates have doubled in the past 10 years. Firearms account for 44% of suicide deaths in adolescents and nearly 90% of suicide attempts with a firearm result in death. Most firearm-related suicide deaths involve a weapon that was obtained within the victims household. Medication ingestion is the most common means of suicide attempt. Lethal means counseling often includes discussion with families about access and storage of home medications.

Lethal means counseling is one of the few suicide prevention interventions found to decrease suicides. It is based on the concept that reducing access to lethal means of suicide during a time of vulnerability can prevent suicide by decreasing the lethality of attempts. This is of critical importance in adolescence, when the transition from ideation to action is often sudden and unplanned, using the most readily available method to attempt suicide. Data shows that lethal means counseling by providers is acceptable and has potential to affect home access or storage of lethal means.

This workshop will review the existing literature, the JACHO requirements, current applications, and research gaps related to lethal means counseling in the clinical environment. Facilitators will offer an overview of lethal means counseling and discuss relevant studies in the introduction. We will present various screens that can be used in the clinical setting and what interventions are available when patients or parents report access to lethal means.

During break out sessions our question guide will prompt discussion of topics including: -How your institutions conducts lethal means counseling -Under ideal circumstances how would your institution conduct lethal means counseling -What are the limitations to LMC at your institution? We will wrap up with important resources for doing lethal means counseling, including specific trainings and screenings available.

1) Describe lethal means counseling and some common and novel clinical applications. 2) Understand the existing research and current clinical practice of lethal means screening and counseling. 3) Identify the obstacles and resources available to conduct and implement lethal means counseling in a clinical setting. 4) Discuss the real-world application of lethal means counseling and existing QI and research gaps in small groups.